Camp Register Form

Enter the message as it's shown*

Child 1*

First Name Middle Name Last Name

Gender*

Male Female

Going into Year/Class*

$40 per day includes lunch*

Child 2

First Name Middle Name Last Name

Gender

Male Female

Going into Year/Class

Child 3

First Name Middle Name Last Name

Gender

Male Female

Going into Year/Class

Child 4

First Name Middle Name Last Name

Gender

Male Female

Going into Year/Class

If you have additional children please contact us.

Phone Number*

Area Code Phone Number

Emergency Contact*

First Name Last Name

Phone Number*

Area Code Phone Number

Relationship*

To complete payment:

1) Bank Transfer: BSB 126563 Acc 21844174 (leave REF name &CGI)

2) By credit card call 0426963125

3) Pay on the day when you drop the kids off

Payment

Agreement*

I am signing up my child for camp. I give my child permission to attend all trips and receive medical care in the case of emergency, G-d forbid. I give Gan Israel permission to photograph and videotape my children and use the photos and videos (without their names) for whatever the camp sees fit.

General comments, important medical information and allergies

Camp dates: 16-27 January 2023

1. Child/ren’s Information

2. Parent information

3. Emergency Information

4. Payment Information